Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 011109 | MA |
NPI | 1811026560 |
---|---|
Provider Name | Dr. Joseph M Andreas |
First Address | Newburyport, MA 01950-3872 |
Second Address | Newburyport, MA 01950-3872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 09/07/2007 |